Add NPs to reduce emergency visits in half, coordinate care

Hospitals trying to reduce emergency department (ED) crowding should look to new research from Loyola University Health System (LUHS), which found that adding a nurse practitioner (NP) to staff can cut unnecessary ED visits in half.

After adding an NP to an inpatient surgical team who coordinated the discharge plan and communicated with patients after discharge, telephone conversations with patients jumped 64 percent and visiting nurse, physical therapy, or occupational therapy services rose from 25 percent to 39 percent, according to the study. In addition to improving patients' use of hospital resources, NP involvement also led to a 50 percent drop in unnecessary ED visits.

"This study demonstrates the important role that nurse practitioners have in our increasingly complex health-care system," said senior author Dr. Margo Shoup, the division director of Surgical Oncology at LUHS, in a statement last week. "With resident work restrictions and changes in reimbursement, the addition of a nurse practitioner to a busy practice can fill a void and maintain communication and care after a patient is released from the hospital."

In particular, the NP regularly monitored patients' progress, ordered lab tests, called in prescriptions, and arranged to care for patients in the outpatient setting, LUHS researchers noted.

And with limited resident work hours and a looming physician shortage, adding NPs to hospital staff could help ensure continuity of care.

FEATURED ADVISOR

Frank D. Byrne, M.D.
President
St. Mary's Hospital

Frank Byrne, M.D., is president of St. Mary's Hospital, a 440-bed hospital in Madison, Wisc., where he helped complete a $182-million expansion, the transition to an electronic health record and the opening of a free-standing satellite emergency center. He is also a contributor to the Hospital Impact blog.